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#QRS > 0.12 in limb leads  
==Evaluation==
#Triphasic QRS (rSR'), often w/ ST depression & TWI in V1-V3  
[[File:Bundle Branch Block.png|thumbnail]]
##V1 must have a positive complex  
*QRS > 0.12 in limb leads  
#Slurred S in 1 and V6
*Triphasic QRS (rSR') or biphasic (qR), often with ST depression & TWI in V1-V3  
[[File:RBBB.jpg|thumb|center|500px|RBBB]]
**V1 must have a positive complex  
**Second R wave in V1 is ''always'' taller than the first (rSR')
*Slurred S in 1 and V6
*ST depression and TWI in other leads should arouse suspicion
*'''Any ST elevation is abnormal in RBBB and must prompt evaluation for [[STEMI]]'''
[[File:Rbbb morphology lead vi wm.jpg|thumbnail|RBBB V1 Morphologies]]
[[File:RBBB.jpg|thumb|RBBB]]
 
==Differential Diagnosis==
{{Tachycardia (wide) DDX}}


==See Also==
==See Also==
*[[ECG (Basics)]]
*[[ECG (Basics)]]


== Source ==
==References==
*Adapted from Niemann, Lampe, Pani, Donaldson, ECGpedia.org
<references/>
*Journal of Electrocardiology. Vol 43 (2010). 40-42.
*Journal of Electrocardiology. Vol 43 (2010). 40-42.


[[Category:Cards]]
[[Category:Cardiology]]

Latest revision as of 06:36, 5 April 2019

Evaluation

Bundle Branch Block.png
  • QRS > 0.12 in limb leads
  • Triphasic QRS (rSR') or biphasic (qR), often with ST depression & TWI in V1-V3
    • V1 must have a positive complex
    • Second R wave in V1 is always taller than the first (rSR')
  • Slurred S in 1 and V6
  • ST depression and TWI in other leads should arouse suspicion
  • Any ST elevation is abnormal in RBBB and must prompt evaluation for STEMI
RBBB V1 Morphologies
RBBB

Differential Diagnosis

Wide-complex tachycardia

Assume any wide-complex tachycardia is ventricular tachycardia until proven otherwise (it is safer to incorrectly assume a ventricular dysrhythmia than supraventricular tachycardia with abberancy)

^Fixed or rate-related

See Also

References

  • Journal of Electrocardiology. Vol 43 (2010). 40-42.